Cardiovascular risk in hypertensive individuals: relationships between physical activity, heart rate variability, and metabolic–psychological factors

Abstract Objective To analyze cardiovascular risk in hypertensive individuals and its relationships with physical activity, heart rate variability, and metabolic-psychological factors. Methods This was a cross-sectional study including 59 hypertensive participants allocated into three groups according to their level of physical activity: hysically active (AT), Irregularly active (IA), and sedentary (SDT). Analyses included assessment of heart rate variability, biochemical parameters, sleep quality, symptoms of anxiety and depression, cardiovascular risk, and renal function. Results The main findings demonstrated that physically active individuals presented greater parasympathetic modulation ( p = 0.027), whereas sedentary participants exhibited sympathetic predominance ( p = 0.022) and a higher LF/HF ratio ( p = 0.025), suggesting an imbalance in sympathovagal balance. A correlation was also observed between higher levels of physical activity and lower autonomic imbalance ( r = -0.327; p = 0.011), as well as associations between cardiac stress index and cardiovascular risk ( r = 0.294; p = 0.023), anxiety levels ( r = 0.258; p = 0.048), total cholesterol and renal function ( r = -0.260; p = 0.046). The remaining variables showed no statistically significant differences. Conclusion Physically active hypertensive individuals presented a better cardiac autonomic modulation and, consequently, lower cardiovascular risk.